Definition

Diabetes is a higher level of glucose in the blood than is normal. Glucose travels through the body in the blood. A hormone called insulin then helps glucose move from the blood to the cells. Once glucose is in the cells it can be used for energy. A problem making or using insulin means glucose cannot move into cells. Insulin also helps glucose to move into the liver for storage if there is too much to use. Without enough insulin, glucose will build up in the blood.

In type 1 diabetes, the body does not make insulin. This will lead to the build up of glucose in the blood, also called hyperglycemia. At the same time, cells are not getting glucose they need to function well. Over a long period of time high blood glucose levels can also damage vital organs. The blood vessels, heart, kidneys, eyes, and nerves are most commonly affected organs.

Type 1 diabetes is often found during childhood and young adulthood.

Causes

Our immune system keeps us well by fighting off and destroying viruses and bacteria. Unfortunately, sometimes the immune system attacks healthy tissue. Most type 1 diabetes develop because the immune system attacks and destroys the cells that make insulin. These cells are in the pancreas.

It is not yet clear why the immune system attacks these cells. It is believed that some people have genes that make them prone to getting diabetes. For these people, certain triggers in the environment may make the immune system attack the pancreas. The triggers are not known but may be certain viruses, foods, or chemicals.

Type 1 diabetes may also develop as a complication of other medical conditions. It may develop in:

Symptoms

Type 1 diabetes may cause:

Increased urination

Extreme thirst

Hunger

Weight loss

Fatigue, weakness

Blurry vision

Irritability

Headaches

Without insulin, the body will need to find new forms of energy. This will cause an imbalance in the body called
ketoacidosis.
It is a severe state that can lead to coma or death. Ketoacidosis may cause:

Treatment

Diabetes treatment goal is to maintain blood sugar at levels as close to normal as possible. Regular medical care is important for preventing or delaying complications.

While diabetes makes blood glucose levels too high, treatment can make blood glucose levels go too low. This is called hypoglycemia. It can cause confusion, shakiness, anxiety, heart palpitations and more. If the levels fall too low it can cause seizures and loss of consciousness.

Medication and diet will be adjusted to prevent hyperglycemia and keep the risk of hypoglycemia low.

Insulin

Insulin injections replace the insulin that is missing. The amount given is based on individual need and a blood glucose test that is taken before and after meals and at bedtime. Insulin shots will be needed 2 or more times daily. There is one short-acting inhaled insulin which may be available for select persons.

An insulin pump can automatically deliver small amounts of insulin through the day.

Insulin may be available in inhaled forms.

Pramlintide

Amylin is made in the pancreas along with insulin. In people with type 1 diabetes, this hormone, like insulin, is missing. The missing amylin may be responsible for the blood glucose rise after a meal in
people with
diabetes. The drug pramlintide may be used in adults when insulin therapy is not enough to control blood sugar.

Glucagon

Glucagon can be injected to quickly increase blood glucose level. People with type 1 diabetes should always have an emergency supply available in case of hypoglycemia.

A medical alert ID can let others know of the condition if communication is impacted.

Other Medications

Vaccinations will be needed. Some may be needed earlier in children with diabetes.

Diet

Meet often with a registered dietitian. Generally speaking, it is best to:

Follow a well-balanced meal plan with a variety of food groups.

Eat at regular times each day. Include a bedtime snack. Do not skip meals

Avoid highly refined carbohydrates. This includes sugar or high fructose products like soda.

Exercise

Exercise is encouraged as long as blood glucose levels are under control. The doctor will advise activity levels and changes that may need to be made.

The insulin dose or diet may need to be adjusted if glucose levels are low after exercise.

Blood Sugar Testing

Regular blood glucose checks throughout the day will help manage diabetes. Testing is often done with a blood glucose monitor. Continuous monitoring systems that are worn all day are also available.

Keep a record of the results to show the doctor. The treatment plan may change based on test results. The
HbA1c blood test is also used by the doctor to assess overall glucose control.

Pancreatic Islet Cell Transplant

This is a procedure that is still being investigated. It involves transplanting islet cells from a donor to a person with type 1 diabetes. After the transplant, these new cells are able to produce insulin. In some cases, people who receive these transplants may no longer need insulin injections.

Closed-Loop Artificial Pancreas

This device is still being studied and developed. It is a continuous glucose monitoring system (CGMS). This system can automatically checks glucose levels through the day. Insulin is then delivered as needed through the day and night. The monitoring system will help keep blood sugar levels within the normal range without daily testing or injections.

Pancreatic Transplant

Acute diabetic complications or emergencies can not be prevented by insulin

Severe problems occur due to injecting large amounts of insulin

Severe and frequent complications related to diabetes occur, such as severe recurrent hypoglycemia

Counseling

Depression can undermine recovery and increase the risk of other complications. Feelings of sadness, hopelessness, and loss of interest in activities that last for at least 2 weeks should prompt a call to the doctor. Depression is treatable. Counseling can help better manage depression and diabetes.

Complications

Over a long period of time, high blood glucose levels can damage vital organs. The risk of complications increases with increasingly poor control

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.